Ebola outbreak: Stricken US missionary staff ‘improving’ after taking experimental serum

Doses of the unproven 'ZMapp' treatment had only previously been tested on monkeys

As the health of two Ebola-stricken American missionaries deteriorated late last month, an international relief organisation backing them hunted for a medical miracle. The clock was ticking, and a sobering fact remained: most people battling the disease do not survive.

Leaders at Samaritan’s Purse, a North Carolina-based Christian humanitarian group, asked officials at the Centres for Disease Control and Prevention (CDC) whether any treatment existed – tested or untested – that might help save the lives of Kent Brantly and Nancy Writebol, who both contracted Ebola while helping patients in Liberia.

The CDC put the group in touch with National Institutes of Health (NIH) workers in West Africa, where staff knew about promising research the US government had funded on a serum that had been tested only in monkeys.

“Our staff in Liberia knew about the research and flagged it for the religious groups,” said Anthony Fauci, director of the NIH’s National Institute of Allergy and Infectious Diseases. Within days, doses of the unproven treatment had made their way in frozen vials across the ocean and were administered to Brantly and Writebol. “This so-called experimental serum is a cocktail of antibodies that have the capability of blocking the virus,” said Mr Fauci. “The physicians in charge of the patients’ care made a risk-benefit decision. The risk was less than the potential benefit.”

While it is too early to say whether the treatment saved the lives of the two missionaries or slowed the disease’s progression enough to allow them to return to the US for care, some reports have suggested that Brantly and Writebol were “improving” after receiving it.

 

Palmer Holt, a spokesman for Service in Mission, a Christian relief group that employs Nancy Writebol, said she has had “good days and bad days”. But he added that while her condition was worsening on 30 July, the day before she first received the treatment, she seemed to stabilise in the days that followed.

Ahead of her arrival at Emory University Hospital in Atlanta today, she had received a second dose of the serum. “She’s showing improvement,” said Mr Holt via email. “She is walking with assistance... strength is better... has an appetite.”

There is no approved cure for Ebola and no proven vaccine to prevent the disease. Part of the problem has been a lack of interest from drug companies, given that Ebola has affected relatively few people.

The drug cocktail the two Americans received, known as “ZMapp”, was developed by the San Diego company, Mapp Biopharmaceutical. It is manufactured in Kentucky using fast-growing tobacco plants, which act as “photocopiers” to produce proteins that are extracted from the plants and processed into the drug, said a spokeswoman for Kentucky BioProcessing, the firm that works with Mapp.

An electron micrograph of the Ebola virus An electron micrograph of the Ebola virus
The medication builds on previous efforts to develop anti-Ebola drugs. According to a 2012 study in the journal Science Translational Medicine, four monkeys survived after receiving a precursor of ZMapp a day after being infected with the Zaire strain of the virus, the one that is currently infecting West Africans. In another group, two out of four monkeys survived when given the drug 48 hours after infection.

ZMapp was first identified as a drug candidate in January, and very little of it is available. Mapp said it and its partners “are cooperating with appropriate government agencies to increase production as quickly as possible”.

Last week, federal officials announced that they have fast-tracked development of an Ebola vaccine and plan to start formal human trials next month. The potential vaccine has shown encouraging results in primates. 

Washington Post

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